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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 9/28/2015 <br />Submitted on: 9/25/2015 10:00:02AM <br />Submitted by: rupinder padda Email: msspetroinc@yahoo.com <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />OW0003048 <br />RUPINDER PADDA <br />2420 W TURNER RD <br />LODI, CA 95242 <br />209-914-8735 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0004139 <br />Facility name <br />Plaza liquor and Gas <br />Site address <br />2420 W TURNER <br />City <br />LODI <br />ZIP code <br />95242 <br />Facility phone <br />209-369-1960 <br />Facility mailing address <br />2420 W TURNER RD <br />ARIS VELOSO <br />LODI, CA 95242 <br />BILLING INFORMATION <br />PR0507754 <br />Contact name <br />Plaza liquor and Gas <br />Address <br />2420 W TURNER RD <br />FATINAH ZAREEF <br />LODI, CA 95242 <br />Contact phone <br />Not Specified <br />Contact email <br />LAKEWOODCHEV@YAHOO.COM <br />Mail invoices to <br />Account <br />CERS ID: 10181595 <br />Facility ID in CERS: FA0004139 <br />Information after CIW processing CERS <br />(current submittal) field <br />RUPINDER PADDA 111 <br />2420 W, TURNER RD 113 <br />LODI, CA 95242 114, 115, 116 <br />2099148735 112 <br />Plaza liquor and Gas 3 <br />2420 W TURNER RD 103 <br />LODI 104 <br />95242 105 <br />209-369-1960 102 <br />2420 W. TURNER RD 108a <br />LODI, CA 95242 108b, 108c, 108d <br />RUPINDER PADDA 140 <br />2420 W, TURNER RD 143 <br />LODI, CA 95242 144, 145, 146 <br />209-914-8735 141 <br />LAKEWOODCHEV@YAHOO.COM 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST <br />New PR#: <br />New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: Date: <br />-------------------------------------------------- <br />Accounting: Reviewed by: VP Date: 11M //S Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />-------------------------------------------------- <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description <br />Record ID <br />Employee name <br />Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location <br />PR0519912 <br />JAMIE DE LA ROSA <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONSNR <br />PRO518103 <br />ARIS VELOSO <br />Active (] [ ] <br />2361 - UST FACILITY <br />PR0231382 <br />ARIS VELOSO <br />Active [ ] [ ] <br />2301 - UST STATE SURCHARGE FEE <br />PR0507754 <br />FATINAH ZAREEF <br />Inactive [ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />PR0507581 <br />FATINAH ZAREEF <br />Inactive [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI <br />PR0534242 <br />not assigned <br />Inactive [ l [ ] <br />